What You Need to Know About Bedwetting (Enuresis) and How To Stop It

Enuresis is a common problem that affects more than 5 million children in the United States alone. When a child empties their bladder at an inappropriate time and/or place it is called incontinence, but when incontinence happens during the night it is classified as enuresis. Enuresis can be embarrassing, stressful, and can even cause extreme anxiety in children, which can then cause tension within the family. While most children will outgrow enuresis, it’s still important to know the different causes and possible treatment options to discuss with your doctor.

Common Causes

Doctors now believe that the majority of enuresis cases are caused by one, or a combination of the following four conditions.

• Failure to arouse – this happens when a child does not wake up when their bladder is full or contracts spontaneously.
• Increased production of urine while asleep – a child’s kidneys make more urine during the night than can be stored within the child’s bladder. This extra urine production is caused by a night-time lack of the hormone vasopressin, which tells the kidneys to decrease urine production.
• Overactive bladder – the bladder tends to contract without being full leading to a smaller than normal capacity.
• Social stress – moving to a new place, sleeping alone, starting school or changing to a new one, a family crisis, an accident or trauma can all cause enuresis in children who are genetically predisposed to the condition.

Uncommon Causes

While the following causes aren't very common reasons for enuresis, they do serve as a reminder to get enuresis symptoms and issues checked by a doctor.

• Urinary Tract Infections
• Structural or Anatomical Issues
• Neurological Issues
• Kidney Disease
• Hormonal Disorders such as Diabetes or Hypothalamus issues

Treatment Options

• Stopping/limiting fluids before bedtime – typically one of the first things parents try, just make sure your child is drinking a few extra glasses of water in the morning and at lunch and then limit evening drinking intake to quench thirst only.
• Dietary changes – enuresis can be caused by constipation, dietary changes or laxatives can eliminate constipation and in return the enuresis as well.
• Scheduled night waking – while labor intensive and often not recommended, parents wake children 1-3 times during the night to take them to the bathroom.
• Bladder training exercises – mainly used for adults who suffer with various forms of incontinence, typically not recommended for children.
• Alternative therapies – acupuncture and hypnotherapy have had encouraging research and results, while homeopathy, herbal remedies, and chiropractic practices have all been tried, but have no proven effects or research to back them.
• Enuresis alarms – often called wetting alarms are small electronic devices that use a small sensor that attaches to underwear or pajamas that then connects to an alarm clipped to the child’s clothing(wireless options are also available now). When the sensor becomes moist the alarm sounds in hopes of the child waking while the bladder is still full and making it to the bathroom. If it is used correctly the chance of success is approximately 75% after 1-2 months of continuous treatment. Wetting alarms cost around $60 to $120.
• Desmopressin acetate (DDAVP) – humans naturally produce the hormone vasopressin that causes the body to reduce urine production. In many children with enuresis, this surge of vasopressin is absent, so the vasopressin hormone has been analyzed and synthesized as the drug desmospressin, and is available as a pill, nasal spray, or as an under the tongue option.
• Medication – there are a few other medications on the market that could help with enuresis, but like any medicine, they can come with side effects. The most common side effect for children is constipation, which, in itself, may cause the enuresis to reappear. Be sure to consult with your doctor about all treatment possibilities.

"Bedwetting (Nocturnal Enuresis) in Children." Bedwetting (Nocturnal Enuresis) . Boston Children's Hospital, 1 Jan. 2014. Web. 30 Dec. 2014.

"Urology Care Foundation The Official Foundation of the American Urological Association."Urology Care Foundation. 28 Mar. 2013. Web. 30 Dec. 2014.

"When Bed-Wetting Becomes A Problem." Nation Kidney Foundation. Web. 30 Dec. 2014.